Since the rabies virus enters the human body through a bite or scratch, it is imperative to remove as much saliva, and thereby the virus, from the wound as is possible by an efficient wound toilet. Since the rabies virus can persist and even multiply at the site of bite for a long time, wound toilet must be performed even if the patient reports late. This can be done by prompt and gentle thorough washing with soap or detergent and flushing the wound with running water for 10 minutes. If soap and detergent are not immediately available wash with running water for at least 10 minutes. Avoid direct touching of wounds with bare hands.

It should be noted that the immediate washing of the wound is a priority. However, the victim should not be deprived of the benefit of wound toilet as long as there is an unhealed wound, which can be washed even if the patient reports late. The maximum benefit of the wound washing is obtained when fresh wound is cleaned immediately. Suturing of wound should be avoided as far as possible. If unavoidable, minimum loose sutures should be applied after adequate local treatment along with proper infiltration of anti-rabies serum.

Cauterization of wound is no longer recommended as it leaves very bad scar, and does not confer any additional advantage over washing the wound with water and soap. Inj. tetanus toxoid should be given to the unimmunized individual. To prevent sepsis in the wound, a suitable course of an antibiotic may be recommended.

➡️Application of antiseptic

After thorough washing and drying the wound, any one of the available antiseptic agents should be applied: Savlon (in appropriate recommended dilution), Dettol (in appropriate recommended dilution), povidone iodine, alcohol etc.

➡️Local infiltration of rabies immunoglobulins

In category III bites rabies immunoglobulins should be infiltrated in the depth and around the wound to inactivate the locally present virus.